Topic Contents

Dilated Cardiomyopathy

Topic Overview

What is dilated cardiomyopathy?

Dilated cardiomyopathy is a serious condition that weakens your heart muscle and
causes it to stretch, or dilate. When your heart muscle is weak, it can't pump
out blood as well as it should, so more blood stays in your heart after each
heartbeat. As more blood fills and stays in the heart, the heart muscle
stretches even more and gets even weaker.

Most of the time, this
leads to
heart failure. Heart failure does not mean that your
heart stops pumping. It means that your heart can't pump enough blood to meet
your body's needs.

What causes dilated cardiomyopathy?

The most
common type of dilated cardiomyopathy develops after a heart attack has damaged
the heart muscle. But it can also be caused by many diseases or problems that
may or may not be related to your heart. Sometimes the cause is not known.

Myocarditis,
which is inflammation of the heart muscle. It is caused by a virus or an immune
system problem.

Drinking too much alcohol, using certain illegal drugs such as
cocaine, or taking certain medicines such as
chemotherapy.

Being exposed to toxic
metals, such as lead or mercury.

Being pregnant. In rare cases,
dilated cardiomyopathy develops toward the end of pregnancy or during the first
6 months after a woman gives birth. Experts don't know why this happens.

What are the symptoms?

You may not have any
symptoms at first. Or you may have mild symptoms, such as feeling very tired or
weak.

If your heart gets weaker, you will develop heart failure.
When this happens, you will feel other symptoms, including:

Shortness of breath, especially with
activity.

Tiredness.

Trouble breathing when you lie
down.

Swelling in your legs.

You may get these symptoms slowly, over months or years.
Or you may get them suddenly, such as after pregnancy or an illness caused by a
virus.

Heart failure that suddenly gets worse is an emergency. Get
medical help right away if:

You have severe trouble breathing.

You cough up pink, foamy mucus.

You have a new irregular or rapid heartbeat.

When you have heart failure, keeping track of your symptoms every
day is important. Call your doctor if:

You have a sudden weight gain such as
3 lb (1.4 kg) or more in 2 to 3
days.

Your ability to exercise changes.

You have
any change in your symptoms.

How is dilated cardiomyopathy diagnosed?

Your
doctor will ask questions about your symptoms and past health. He or she will
want to know about recent illnesses and about heart disease in your family.
Your doctor will listen to your heart and lungs and check your legs for fluid
buildup.

How is it treated?

You will probably need to take several medicines to treat heart failure caused by dilated cardiomyopathy. It is very important to take your medicines exactly as your doctor tells you to and to keep taking them. If you don't, your heart failure could get worse.

Your doctor may suggest a mechanical device to help your
heart pump blood or to prevent life-threatening irregular heart rhythms. Such
devices include a
pacemaker for heart failure (also called cardiac resynchronization therapy or CRT), an
implantable cardioverter-defibrillator (ICD), or a
combination pacemaker and ICD. If your condition is very bad, a heart
transplant may be an option.

Self-care is an important part of your treatment. Self-care includes the things you can do every day to feel better, stay healthy, and avoid the hospital.

Take your medicines as prescribed. This gives you the best chance of being helped by them. Some medicines for heart failure include:

Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs). These make it easier for blood to flow.

Diuretics. These help remove excess fluid from the body.

Beta-blockers. These slow the heart rate and can help the heart fill with blood more completely.

Live a healthy lifestyle. It can help slow down heart failure. Limit salt, try to get regular exercise, and don't smoke.

Watch for signs you're getting worse. Weighing yourself every day to watch for sudden weight gain is a good way to do this.

Find out what your triggers are, and learn to avoid them. Triggers are things that make your heart failure worse, often suddenly. A trigger may be eating too much salt, missing a dose of your medicine, or exercising too hard.

What can you expect with dilated cardiomyopathy?

Most of the time, dilated cardiomyopathy leads to heart failure. Heart
failure usually gets worse over time, but treatment can slow the disease and
help you feel better and live longer. In more and more cases, the problem is
being found earlier, when it can be better managed.

Sudden cardiac death, which means the heart suddenly stops
working. This may be more likely to happen to people who have serious rhythm
problems (arrhythmias) in one of the lower heart chambers (ventricles).

If a woman gets dilated cardiomyopathy from pregnancy,
she should not get pregnant again. This is true even if her heart problem gets better.

If your disease is getting worse, you may
want to think about making end-of-life decisions. It can be comforting to know
that you will get the type of care you want.

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Yancy CW, et al. (2013). 2013 ACCF/AHA Guideline for the management of heart failure: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology, 62(16): e147–e239.

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